Our Summary

This study looked at the effectiveness and safety of a procedure called laparoscopic splenectomy for patients with an enlarged spleen due to liver cirrhosis. This procedure is considered the best option for removing normal or slightly larger spleens for non-cancerous conditions, and can also be used for malignant spleen disorders. However, its safety for patients with an overly large spleen (hypersplenism) was not well-known.

To find out more, the researchers looked at several studies conducted from January 2000 to June 2015 that compared laparoscopic splenectomy with a more traditional open splenectomy for patients with liver cirrhosis.

The researchers found that patients who had laparoscopic splenectomy had less blood loss during surgery, although the operation took slightly longer. They also found that patients who had the laparoscopic procedure spent less time in the hospital after surgery, had fewer post-surgery complications, and had less liver damage.

As a result, the researchers concluded that having an enlarged spleen due to liver cirrhosis and high blood pressure in the liver should not prevent patients from having a laparoscopic splenectomy.

FAQs

  1. What is a laparoscopic splenectomy and when is it typically used?
  2. How does the safety and effectiveness of laparoscopic splenectomy compare to traditional open splenectomy for patients with an enlarged spleen due to liver cirrhosis?
  3. What were the main findings from the studies comparing laparoscopic splenectomy and traditional open splenectomy for patients with liver cirrhosis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about splenectomy is to follow post-operative care instructions carefully, including taking prescribed medications, avoiding heavy lifting and strenuous activity, and attending follow-up appointments. It is important to monitor for signs of infection, such as fever or redness at the incision site, and report any unusual symptoms to your healthcare provider promptly. Additionally, patients who have had their spleen removed should be aware of the increased risk of certain infections and should discuss vaccination options with their doctor.

Suitable For

Patients who are typically recommended for splenectomy include those with conditions such as:

  • Enlarged spleen due to liver cirrhosis
  • Hypersplenism (overly large spleen)
  • Malignant spleen disorders
  • Non-cancerous conditions causing spleen enlargement

Overall, the study suggests that laparoscopic splenectomy is a safe and effective option for patients with an enlarged spleen due to liver cirrhosis, and may offer advantages such as less blood loss, shorter hospital stays, and fewer post-surgery complications compared to traditional open splenectomy.

Timeline

Timeline before and after splenectomy:

Before splenectomy:

  1. Patient undergoes various tests and evaluations to determine if splenectomy is necessary and safe for their condition.
  2. Patient may need to stop taking certain medications or make lifestyle changes in preparation for surgery.
  3. Surgery is scheduled and patient receives pre-operative instructions from their healthcare team.

After splenectomy:

  1. Patient undergoes laparoscopic splenectomy procedure.
  2. Patient may experience some pain and discomfort after surgery, which can be managed with pain medication.
  3. Patient is monitored closely for any signs of complications, such as infection or bleeding.
  4. Patient is discharged from the hospital and instructed on post-operative care, including wound care and activity restrictions.
  5. Patient follows up with their healthcare team for post-operative appointments and monitoring of their condition.
  6. Patient may need to receive vaccinations or take antibiotics to prevent infections, as the spleen is an important part of the immune system.
  7. Patient may need to make certain lifestyle changes, such as avoiding contact sports or activities that increase the risk of infection.
  8. Patient gradually resumes normal activities and may need to follow up with their healthcare team regularly to monitor their health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about splenectomy include:

  1. What are the potential risks and complications associated with splenectomy, particularly in my specific case (e.g. liver cirrhosis)?
  2. How will splenectomy affect my overall health and quality of life in the long term?
  3. Are there alternative treatments or procedures that could be considered instead of splenectomy?
  4. What is the recovery process like after splenectomy, and how long can I expect to be out of work or daily activities?
  5. Will I need any special vaccinations or medications after splenectomy to prevent infections?
  6. How often will I need follow-up appointments or monitoring after the procedure?
  7. What can I do to support my recovery and minimize potential complications after splenectomy?
  8. Are there any specific lifestyle changes or restrictions I should be aware of after splenectomy?
  9. How will splenectomy affect my immune system and my body’s ability to fight infections?
  10. Can you provide me with more information about the specific procedure you recommend and why it is the best option for me?

Reference

Authors: Al-raimi K, Zheng SS. Journal: Hepatobiliary Pancreat Dis Int. 2016 Feb;15(1):14-20. doi: 10.1016/s1499-3872(16)60053-x. PMID: 26818539